One commonly voiced community concern with regard to a syringe exchange program
(SEP) is the fear of a “needlestick injury” resulting from improperly discarded syringes in
parks, gutters, or garbage bags. SEPs provide sterile syringes to reduce the spread of HIV,
hepatitis and other blood borne illnesses and link injection drug users (IDUs) to health
promotion services such as medical and mental health treatment. SEPs actively
encourage and educate clients about safe disposal in order to lessen the number of
improperly discarded syringes. In addition, SEPs supply puncture-proof ‘sharps’
containers and information on safe disposal discard used syringes to every client who
utilizes the program.

The Coalition for Safe Needle Disposal lists syringe exchange
programs as a viable option for safe disposal.1
Risk of Infection
The risk of becoming infected with a blood borne virus through a needlestick is extremely
low. A recent review analyzing studies of HIV transmission risk through needlestick injuries among health care workers estimated the risk of infection to be less than 1 in 400
(0.23%)2. In the majority of studies reviewed, no cases of transmission were documented
following needlestick injuries. Risk of infection from needlesticks in community settings
(outside health care facilities) appears to be negligible. Studies of community
needlestick injuries (primarily among children) in England3, Ireland4, Spain5, Italy6,
Australia7, and South Africa8 found no cases resulting in infection.
The reasons for a relatively low risk of infection include:
• Not all used needles carry a virus.
• While HIV and other blood borne diseases can survive outside the body in a used
needle, these viruses are very fragile, and will often die if subject to external
environmental conditions, such as air or water.
• Most needlestick injuries are superﬁcial and carry far less risk of virus transmission than
intravenous drug use, where needles directly enter veins.
Syringe exchange programs: improving the safety of their community
There is a particular need for safe disposal methods for IDUs, who might be apprehensive
to carry syringes (especially used ones) because of their fear of law enforcement.9
Paraphernalia laws discourage IDUs from carrying or properly disposing of syringes.10 Yet,
research demonstrates that the presence of a SEP results in fewer used syringes
improperly discarded.11
• SEPs provide a safe and accessible method for IDUs and others to
dispose of used syringes. Similar to hospitals and other healthcare
settings, used syringes are collected in special puncture-proof
“sharps” containers. These containers are picked up and safely
Harm Reduction Coalition

disposed of according to special procedures designated for hazardous waste.
• The vast majority of syringes distributed by SEPs are returned. In many states,
including New York, syringe exchange policies actively encourage participants to
return as many used syringes as possible.12
• In New York State, all syringe exchange staff receive training by the State Health
Department that outlines precautions to avoid a needle stick injury, appropriate safe
disposal methods, and procedures to clean an accidental blood spill. Most SEPs
offer safe disposal as a community resource and are called upon to retrieve used
syringes in public spaces.